If you've been paying rapt attention while Barack Obama or Elizabeth Edwards talk about health care reform, you'll have undoubtedly noticed that both place a lot of emphasis on the expansion of preventative care as a way to lower long-term health costs. It's actually kind of a basic thing: if you keep your cholesterol under control, you might not need expensive bypass surgery; if you can keep your diabetes controlled, you may avoid long-term complications like kidney failure and amputation; if you get pre-natal care, you can increase your chances of having a health (and thus less expensive) child.In fact, in a health care system that financially rewards doctors for emergent care more than intermittent preventative care, encouraging people to seek preventative care regularly is better for the financial and physical health of everyone involved. You'd think that the people in charge of pricing your health insurance would know that. But as today's New York Times reports, you'd be wrong. According to a study by the Times, women in the individual insurance market — the one McCain wants us to get our health insurance from if he becomes President — pay significantly higher premiums throughout their working lives than men do. In cases from Colorado to Florida to Ohio (swing states all!) women could expect to pay between 22 and 49 percent more than their male counterparts. (Note that the federal government currently does not allow employer-sponsored health insurance — the kind McCain wishes to wipe from the map — to distinguish between men and women when pricing.) And, according to insurers, there's one basic reason: women use preventative care.

In general, insurers say, they charge women more than men of the same age because claims experience shows that women use more health care services. They are more likely to visit doctors, to get regular checkups, to take prescription medications and to have certain chronic illnesses.

Oh, the same insurance company apologist try out the whole load of shit that it's about the expenses of being the ones that push out the babies, but even in states that allow women to opt out of pregnancy coverage, women still pay significantly more. Like a woman in the article, in fact, I don't have medical coverage if for some reason my multiple birth control methods fail:

Crystal D. Kilpatrick, a healthy 33-year-old real estate agent in Austin, Tex., said: "I’ve delayed having a baby because my insurance policy does not cover maternity care. If I have a baby, I’ll have to pay at least $8,000 out of pocket.'

Marcia D. Greenberger, co-president of the National Women’s Law Center, also points out that, the differential in pricing based on gender, McCain's tax credit for purchasing health insurance — $2,500 for you single ladies out there — will actually erode in value faster for women than men. In the meantime, insurance professionals have one good reason not to make insurance pools gender-neutral:

Cecil D. Bykerk, president of the Society of Actuaries, a professional organization, said that if male and female premiums were equalized, women would pay less but "rates for men would go up." Mr. Bykerk, a former executive vice president of Mutual of Omaha, said, "If maternity care is included as a benefit, it drives up rates for everybody, making the whole policy less affordable."

Oh, well, gosh, Cecil, we wouldn't want to deny men the benefit of really low-priced health care just so our health insurance, that covers of the furtherance of the species, is remotely affordable or obtainable! Have to keep that Viagra cheap for you! Luckily, the head insurance regulator in Maine — probably through her use of preventative care — has a few more brain cells functioning than old Cecil:

Mila Kofman, the insurance superintendent in Maine [where they prohibit gender discrimination in the individual insurance market], said: "There's a strong public policy reason to prohibit gender-based rates. Only women can bear children. There's an expense to that. But having babies benefits communities and society as a whole. Women should not have to bear the entire expense."

In fact, I'll go further than that. The whole purpose of insuring pools of people is to spread the costs across many — you know, sort of like roads and schools and shit. And so taking out the lowest cost group of people increases the cost of those who remain, undermining the fucking purpose of pooling risk. In addition, as I noted above, preventative care does cost more at the outset than never going to the doctor. The difficulty is that, from a long-term perspective — which these insurance companies obviously lack as they pursue quarterly profits and stock prices to to exclusion of their business — is that foregoing preventative care ends up being far more costly when easily preventable problems turn into emergent care. Getting a Pap smear every year might cost your insurance company $150 and treating early cancer that said exam might find might be more expensive, but it's all fucking cheap compared to a hysterectomy with hospital stay and months of chemotherapy and then a lifetime of follow-up care. Of course, in the individual market they can just tell you to fuck off after a year and not renew your coverage, so I guess it might not be that expensive for an insurance company after all. The insurance companies — for all their rationalizations about post-childbirth urinary tract complications late in life being expensive, which is what one spokesman actually claimed as a reason for gender differentials in the Times piece — aren't interested in long-term cost lowering. They are interested in short-term profit maximization and figure that, by the time you're old, they probably won't be your insurance company anyway and, if they are, they can just easily boot you off their rolls. Women Buying Health Policies Pay a Penalty [NY Times] Related: Health Insurance And The Single Girl [Glamocracy] Earlier: Elizabeth Edwards Talks About Issues Unrelated To InfidelityBefore First Pitch, Obama Hits One Out Of The Park